Crystal Raupp

• Conduct thorough billing, chart, and demographic reviews to identify and resolve any issues, ensuring accurate and clean claims submission.
• Monitored updates in quality requirements and provided guidance on quality improvement initiatives and value-based care strategies.
• Focused on enhancing patient experience, promoting health equity, and driving improved patient outcomes through targeted initiatives and care strategies.
• Enhanced clinic participation to drive improvements in quality care, health outcomes, and cost efficiency.

·• Lead and manage a team of 20 PSRs, providing guidance, training, and performance evaluations, while ensuring adherence to company policies and business etiquette.
• Oversee timesheet management for payroll, ensuring accuracy and timely submission for staff.
• Resolve patient, physician, and departmental issues, addressing complaints and ensuring smooth operations.
• Collaborate with Physician Scheduler to resolve scheduling conflicts and maintain accurate physician schedules for proper patient appointments and confirmations.

• Managed patient registration process, confirming data accuracy and completeness.
• Maintained a well-organized front desk, contributing to a welcoming environment for patients and visitors.
• Built and maintained positive working relationships with patients and staff.
• Manage billing processes, including insurance verification, payment posting, deposits, and collection of outstanding balances.
• Ensure HIPAA compliance and maintain strict confidentiality in all patient and staff interactions.
• Develop and implement process improvements, continuously assessing and enhancing workflows at CHV.

• A/R Follow Up on all Commercial/Governmental Payers for AZ, and WA
• Claims resolution for denied reconsideration and appeals
• Reviewing contracts/members insurance policies for appropriate reimbursement
• Adjustments/Authorizations/Working with Refunds for patients and payers
• Moderate coding changes like modifiers, crosswalks and more

• A/R Follow Up on all Commercial Payers
• Claims submission/Claims resolution
• Reviewing contracts/members insurance policies for appropriate reimbursement
• Adjustments/Denials/Appeals/Authorizations/Working with Refunds
• Training on workflow
• Lead of Events committee
• Working with third party collections for reduction of balances/aging AR
• Customer Service with parent calls

• Company Overview: Englewood, CO
• Supervision of 5 employees/Quality Audits on accounts and patient calls
• Resolving escalated patient issues/Customer Service calls
• Accepting/Editing office charges/Coding reviews
• Data Entry, A/R follow up, COB's, Rejections, Eligibility/Aging Reports
• Refunds, uploading claims, Payment Plans, Statement loading
• Unapplied money, Payment Posting, Adjustments, Patient Collections
• Englewood, CO